Allergology International最新文献_第4页

Use of explainable AI on slit-lamp images of anterior surface of eyes to diagnose allergic conjunctival diseases 利用眼球前表面裂隙灯图像上的可解释人工智能诊断过敏性结膜疾病。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.07.004

Michiko Yonehara , Yuji Nakagawa , Yuji Ayatsuka , Yuko Hara , Jun Shoji , Nobuyuki Ebihara , Takenori Inomata , Tianxiang Huang , Ken Nagino , Ken Fukuda , Tatsuma Kishimoto , Tamaki Sumi , Atsuki Fukushima , Hiroshi Fujishima , Moeko Kawai , Etsuko Takamura , Eiichi Uchio , Kenichi Namba , Ayumi Koyama , Tomoko Haruki , Dai Miyazaki

Background

Artificial intelligence (AI) is a promising new technology that has the potential of diagnosing allergic conjunctival diseases (ACDs). However, its development is slowed by the absence of a tailored image database and explainable AI models. Thus, the purpose of this study was to develop an explainable AI model that can not only diagnose ACDs but also present the basis for the diagnosis.

Methods

A dataset of 4942 slit-lamp images from 10 ophthalmological institutions across Japan were used as the image database. A sequential pipeline of segmentation AI was constructed to identify 12 clinical findings in 1038 images of seasonal and perennial allergic conjunctivitis (AC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC), and normal subjects. The performance of the pipeline was evaluated by determining its ability to obtain explainable results through the extraction of the findings. Its diagnostic accuracy was determined for 4 severity-based diagnosis classification of AC, AKC/VKC, GPC, and normal.

Results

Segmentation AI pipeline efficiently extracted crucial ACD indicators including conjunctival hyperemia, giant papillae, and shield ulcer, and offered interpretable insights. The AI pipeline diagnosis had a high diagnostic accuracy of 86.2%, and that of the board-certified ophthalmologists was 60.0%. The pipeline had a high classification performance, and the area under the curve (AUC) was 0.959 for AC, 0.905 for normal subjects, 0.847 for GPC, 0.829 for VKC, and 0.790 for AKC.

Conclusions

An explainable AI model created by a comprehensive image database can be used for diagnosing ACDs with high degree of accuracy.

背景：人工智能（AI）是一项前景广阔的新技术，具有诊断过敏性结膜疾病（ACD）的潜力。然而，由于缺乏量身定制的图像数据库和可解释的人工智能模型，其发展缓慢。因此，本研究的目的是开发一种可解释的人工智能模型，它不仅能诊断过敏性结膜炎，还能提供诊断依据：方法：使用来自日本 10 家眼科机构的 4942 张裂隙灯图像数据集作为图像数据库。方法：使用来自日本 10 家眼科机构的 4942 张裂隙灯图像数据集作为图像数据库，构建了一个连续的人工智能分割流水线，以识别 1038 张图像中的 12 项临床发现，这些图像包括季节性和常年性过敏性结膜炎（AC）、特应性角结膜炎（AKC）、春发性角结膜炎（VKC）、巨大乳头状结膜炎（GPC）和正常人。通过对结果的提取，确定其获得可解释结果的能力，从而对管道的性能进行评估。在对 AC、AKC/VKC、GPC 和正常人进行 4 种基于严重程度的诊断分类时，确定了其诊断准确性：结果：人工智能管道分割有效地提取了结膜充血、巨大乳头和盾状溃疡等关键的ACD指标，并提供了可解释的见解。人工智能管道诊断的准确率高达 86.2%，而眼科医师的诊断准确率为 60.0%。管道的分类性能很高，AC的曲线下面积（AUC）为0.959，正常人为0.905，GPC为0.847，VKC为0.829，AKC为0.790：结论：由综合图像数据库创建的可解释人工智能模型可用于诊断 ACD，且准确率较高。

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引用次数: 0

Delayed drug hypersensitivity reactions: How p-i transforms pharmacology into immunology 迟发性药物超敏反应：P-i 如何将药理学转化为免疫学。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.08.006

Werner J. Pichler

Delayed drug hypersensitivity reactions (dDHRs) are iatrogenic diseases, which are mostly due to non-covalent interactions of a drug with the immune receptors HLA and/or TCR causing T-cell activation. This is also known as pharmacological interaction with immune receptors or p-i. P-i activation differs from classical antigen-driven immune reactions: a) drug binding induces structural changes in TCR-HLA proteins which make them look like allo-like TCR-HLA-complexes, able to elicit allo-like stimulations of T cells with cytotoxicity and IFNγ production, notably without the involvement of innate immunity; b) drug binding to TCR and/or HLA can increase the affinity of TCR-HLA interactions, which may affect signaling and IL-5 production by CD4+ T cells, and thus contribute to eosinophilia commonly found in dDHRs or induce oligoclonal T cell expansions; c) Both, antigen and p-i stimulations can induce eosinophil- or neutrophil-rich inflammations; but these stimulations should be distinguished as their underlying mechanism and development differ; and d) p-i stimulation can – like graft versus host reactions – result in long-lasting T-cell activations, which can lead to viremia, occasional autoimmunity, or a new syndrome characterized by multiple drug hypersensitivity (MDH).

In summary, dDHRs are not allergic reactions but represent peculiar T-cell activations, similar to allo-like stimulations. Understanding and considering the p-i mechanism is needed for preventive measures and optimal treatments of dDHR. In addition, it may help to understand TCR signaling, alloreactivity, and may even open a new way of specific immune stimulations.

迟发性药物超敏反应（dDHRs）是一种先天性疾病，主要是由于药物与免疫受体 HLA 和/或 TCR 的非共价相互作用导致 T 细胞活化。这也被称为与免疫受体的药理相互作用或 P-i。P-i 激活与传统的抗原驱动免疫反应不同，它具有以下特点a) 药物结合会引起 TCR-HLA 蛋白的结构变化，使其看起来像异体的 TCR-HLA 复合物，能够引起异体的 T 细胞刺激，产生细胞毒性和 IFNγ，特别是在没有先天性免疫参与的情况下；b) 药物与 TCR 和/或 HLA 结合可增加 TCR-HLA 相互作用的亲和力，这可能会影响 CD4+ T 细胞的信号传导和 IL-5 的产生，从而导致 dDHRs 中常见的嗜酸性粒细胞增多或诱导寡克隆 T 细胞扩增；c) 抗原和 p-i 刺激均可诱发嗜酸性粒细胞或中性粒细胞丰富的炎症；但由于其基本机制和发展过程不同，应将这些刺激区分开来；以及 d) p-i 刺激与移植物抗宿主反应一样，可导致 T 细胞长期活化，从而导致病毒血症、偶发性自身免疫或以多重药物过敏（MDH）为特征的新综合征。总之，dDHR 并非过敏反应，而是一种特殊的 T 细胞活化，类似于异体刺激。需要了解并考虑 p-i 机制，才能采取预防措施和最佳治疗 dDHR。此外，这可能有助于理解 TCR 信号转导、异体反应，甚至可能为特异性免疫刺激开辟一条新途径。

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引用次数: 0

Skin reaction patterns in cholinergic urticaria 胆碱能性荨麻疹的皮肤反应模式。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.07.008

Ilona Shurmelova , Agata Baldyga , Eva Grekowitz , Susanne Kimeswenger , Wolfram Hoetzenecker , Marcus Maurer , Sabine Altrichter

Background

Skin reaction patterns vary across patients with cholinergic urticaria (CholU), but their definition, prevalence, and clinical significance remain ill characterized.

Methods

Patients with CholU underwent pulse-controlled ergometry provocation testing to analyze skin reaction patterns and their correlation with location, onset, severity, sweating behaviour, clinical features, disease control, and quality of life (QoL) impairment.

Results

Based on the size, color, spacing, and shape of wheals as well as their surrounding skin responses, we identified six distinct types of CholU skin reactions, which differed in prevalence, from 83% (Type I) to 11% (Type VI) of patients affected. Almost all patients (94%) had ≥1 type of skin reaction pattern. Sweating was reduced in the majority of CholU patients and most prominently reduced in patients with Type VI skin signs (very small, round, red, widely spaced wheals with surrounding anemic halo), which emerged exclusively on the extremities. Type V skin signs (large, irregular, anemic, widely spaced wheals with moderate size erythema) were associated with the most severe clinical presentation and poorest QoL.

Conclusions

Our analysis showed that most patients have more than one type of skin reaction patterns and that different skin signs are linked to distinct features. Future studies should determine any links between treatment response and types of skin signs in CholU.

背景：胆碱能性荨麻疹（CholU）患者的皮肤反应模式各不相同，但其定义、发病率和临床意义仍不明确：方法：胆碱能性荨麻疹患者接受脉搏控制测力诱发试验，分析皮肤反应模式及其与发病部位、起始时间、严重程度、出汗行为、临床特征、疾病控制和生活质量（QoL）损害的相关性：根据喘息的大小、颜色、间距和形状以及周围皮肤的反应，我们确定了六种不同类型的 CholU 皮肤反应，其发病率各不相同，从 83%（I 型）到 11%（VI 型）不等。几乎所有患者（94%）都有≥1种类型的皮肤反应模式。大多数胆汁淤积症患者的出汗量减少，其中出汗量减少最明显的是 VI 型皮肤症状（非常小的、圆形的、红色的、间距很大的湿疹，周围有贫血晕）患者，这种症状只出现在四肢。V型皮肤征（大的、不规则的、贫血的、间距大的湿疹，伴有中等大小的红斑）与最严重的临床表现和最差的 QoL 有关：我们的分析表明，大多数患者都有一种以上的皮肤反应模式，不同的皮肤症状与不同的特征有关。未来的研究应确定胆碱酯酶抑制剂的治疗反应与皮肤症状类型之间的联系。

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引用次数: 0

Predicting dupilumab effectiveness with Type-2 biomarkers: A real-world study of severe asthma 用2型生物标志物预测杜必鲁单抗的疗效：一项关于严重哮喘的真实世界研究。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.08.005

Kenji Mizumura , Yasuhiro Gon , Norihiro Harada , Shiho Yamada , Asami Fukuda , Ryosuke Ozoe , Shuichiro Maruoka , Sumiko Abe , Kazuhisa Takahashi , Akihiko Tanaka , Hironori Sagara , Taisuke Akamatsu , Toshihiro Shirai , Katsunori Masaki , Koichi Fukunaga , Konomi Kobayashi , Hiroyuki Nagase , Nobuaki Miyahara , Arihiko Kanehiro , Noboru Kitamura , Etsuko Tagaya

Background

The therapeutic effectiveness of dupilumab for severe asthma in real-world settings is yet to be prospectively investigated across multiple institutions, and uncertainties persist regarding predictive factors for its effectiveness. We aimed to assess the effectiveness of dupilumab and identify predictors of its effectiveness in real-world settings using two type-2 biomarkers: FeNO concentration and blood eosinophil count.

Methods

This prospective multicenter study included 103 patients with severe asthma. Exacerbations and respiratory functions were monitored for 24 weeks. Asthma control was evaluated using the Asthma Control Questionnaire-5. Clinical symptoms and their impact on cough and sputum were assessed using the Cough and Sputum Assessment Questionnaire (CASA-Q). Subgroup analyses of type-2 biomarkers were conducted based on FeNO levels and blood eosinophil counts at baseline.

Results

Treatment with dupilumab led to a reduction in exacerbations and enhancement in asthma control, FEV₁, and CASA-Q scores. FEV₁ improvement was correlated with enhancement in the sputum domain of the CASA-Q. Patients exhibiting elevated FeNO levels and blood eosinophil counts demonstrated more significant enhancements in FEV₁. CASA-Q sputum domain scores were significantly higher in the group with elevated eosinophil counts. Regression analysis revealed that FeNO levels and blood eosinophil counts are significant predictors of FEV₁ improvement, with blood eosinophil counts also predicting sputum improvement in patients treated with dupilumab.

Conclusions

Type-2 biomarkers may act as indicators of improvement in FEV₁ and sputum outcomes among patients with severe asthma undergoing dupilumab treatment in real-world settings.

背景：杜比单抗治疗重症哮喘在真实世界环境中的疗效尚未在多个机构中进行前瞻性研究，其疗效的预测因素仍存在不确定性。我们的目的是评估杜必鲁单抗的有效性，并利用两种 2 型生物标志物确定其在实际环境中的有效性预测因素：方法：这项前瞻性多中心研究纳入了103名重症哮喘患者。这项前瞻性多中心研究纳入了 103 名重症哮喘患者，对他们的病情加重情况和呼吸功能进行了为期 24 周的监测。使用哮喘控制问卷-5 评估哮喘控制情况。临床症状及其对咳嗽和咳痰的影响通过咳嗽和咳痰评估问卷（CASA-Q）进行评估。根据基线时的 FeNO 水平和血液嗜酸性粒细胞计数对 2 型生物标志物进行了分组分析：结果：使用dupilumab治疗可减少病情恶化，提高哮喘控制率、FEV1和CASA-Q评分。FEV1的改善与CASA-Q中痰域的改善相关。FeNO 水平和血液嗜酸性粒细胞计数升高的患者 FEV1 的改善更为显著。嗜酸性粒细胞计数升高组的 CASA-Q 痰域得分明显更高。回归分析表明，FeNO水平和血液嗜酸性粒细胞计数可显著预测FEV1的改善，血液嗜酸性粒细胞计数还可预测使用杜匹单抗治疗的患者痰液的改善：结论：在现实世界中，2型生物标志物可作为接受杜比单抗治疗的重症哮喘患者FEV1和痰液改善情况的指标。

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引用次数: 0

Human T follicular helper cells and their impact on IgE and IgG4 production across allergy, malignancy, and IgG4-related disease 人类 T 滤泡辅助细胞及其对过敏、恶性肿瘤和 IgG4 相关疾病中 IgE 和 IgG4 生成的影响。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.07.005

Mitsuhiro Akiyama, Waleed Alshehri, Sho Ishigaki, Koichi Saito, Yuko Kaneko

Human T follicular helper (Tfh) cells play a crucial role in orchestrating B cell differentiation, maturation, and immunoglobulin class switching. Recent studies have underscored the presence of Bcl-6 + Tfh cells not only in secondary lymphoid organs but also within tertiary lymphoid structures at inflammatory sites, emphasizing their pivotal role in disease pathogenesis. Furthermore, Tfh cells have been found to transit between lesion sites, lymph nodes, and peripheral blood, as revealed by T cell receptor repertoire analysis. Among Tfh subsets, Tfh2 cells have emerged as central orchestrators in driving the production of IgE and IgG4 from B cells. Their critical role in diseases such as allergy, malignancy, and IgG4-related disease highlights their profound impact on balancing inflammation and immune tolerance. Our current review provides the molecular characteristics of human Tfh cells, the differentiation pathways of Tfh subsets, mechanisms by which Tfh subsets induce IgE and IgG4 production, and their clinical implications in allergy, malignancy, and IgG4-related disease.

人类 T 滤泡辅助细胞（Tfh）在协调 B 细胞分化、成熟和免疫球蛋白类别转换方面发挥着至关重要的作用。最近的研究强调，Bcl-6 + Tfh 细胞不仅存在于二级淋巴器官中，而且还存在于炎症部位的三级淋巴结构中，从而强调了它们在疾病发病机制中的关键作用。此外，T细胞受体谱分析还发现，Tfh细胞可在病变部位、淋巴结和外周血之间转移。在 Tfh 亚群中，Tfh2 细胞已成为驱动 B 细胞产生 IgE 和 IgG4 的核心协调者。它们在过敏、恶性肿瘤和 IgG4 相关疾病中的关键作用凸显了它们对平衡炎症和免疫耐受的深远影响。本综述介绍了人类 Tfh 细胞的分子特征、Tfh 亚群的分化途径、Tfh 亚群诱导 IgE 和 IgG4 生成的机制，以及它们在过敏、恶性肿瘤和 IgG4 相关疾病中的临床意义。

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引用次数: 0

Regulation of the IgE response by T follicular regulatory cells T 滤泡调节细胞对 IgE 反应的调节。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.08.004

Alexander L. Dent

Allergen-specific IgE is a major mediator of allergic responses and contributes greatly to allergic disease in the human population. Therapies that inhibit the production of IgE would be useful for lessening the burden of allergic disease. A great deal of research has focused on how IgE responses are regulated, and several factors that promote the production of allergic IgE have been characterized. T follicular helper (TFH) cells expressing IL-4 are required for the development of IgE expressing B cells in the germinal center (GC). Ig somatic hypermutation and B cell selection in the GC leads to the development of high affinity allergen-specific IgE that promotes anaphylaxis, a severe form of allergic response. T follicular regulatory (TFR) cells are also found in the GC response and act with TFH cells in the selection of high affinity IgE + B cells. This review examines the current literature on IgE responses and TFR cells. In mouse studies, TFR cells have a suppressive role on IgE responses in allergic airway disease, however TFR cells also play a helper role in the IgE response in food allergy. In human studies, TFR cells correlate with a decreased allergic response but evidence for a direct suppressive role of TFR cells on IgE in vivo is lacking. TFR cells may represent a new target for allergy therapies, but caution must be exercised to promote the suppressor activity of TFR cells and not the helper activity of TFR cells on IgE responses.

过敏原特异性 IgE 是过敏反应的主要介质，在很大程度上导致了人类过敏性疾病。抑制 IgE 生成的疗法将有助于减轻过敏性疾病的负担。大量研究都集中在 IgE 反应是如何被调节的，有几种促进过敏性 IgE 产生的因素已被证实。生殖中心（GC）中表达 IgE 的 B 细胞的发育需要表达 IL-4 的 T 滤泡辅助细胞（TFH）。GC 中的 Ig 体细胞超突变和 B 细胞选择会导致高亲和力过敏原特异性 IgE 的产生，从而引发过敏性休克这种严重的过敏反应。T 滤泡调节（TFR）细胞也存在于 GC 反应中，并与 TFH 细胞一起作用于高亲和力 IgE + B 细胞的选择。本综述探讨了有关 IgE 反应和 TFR 细胞的现有文献。在小鼠研究中，TFR 细胞在过敏性气道疾病的 IgE 反应中起抑制作用，但在食物过敏的 IgE 反应中，TFR 细胞也起辅助作用。在人体研究中，TFR 细胞与过敏反应的减少有关，但目前还缺乏 TFR 细胞对体内 IgE 起直接抑制作用的证据。TFR细胞可能是过敏疗法的一个新靶点，但必须注意促进TFR细胞的抑制活性，而不是TFR细胞对IgE反应的辅助活性。

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引用次数: 0

Quaternary ammoniums activate human dendritic cells and induce a specific T-cell response in vitro 季铵盐在体外激活人类树突状细胞并诱导特异性 T 细胞反应。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.07.003

Marine Peyneau , Mathilde Zeller , Virginie Paulet , Benoît Noël , Marie-Hélène Damiens , Natacha Szely , Andreas Natsch , Marc Pallardy , Sylvie Chollet-Martin , Luc de Chaisemartin , Saadia Kerdine-Römer

Background

In many countries, neuro-muscular blocking agents (NMBAs) are the first cause of perioperative anaphylaxis. Epidemiological studies identified pholcodine, a quaternary ammonium-containing opiate as one of the sensitization sources. However, NMBA anaphylaxis exists in countries where pholcodine was unavailable, prompting the hypothesis of other sensitizing molecules, most likely quaternary ammonium compounds (QACs).

Indeed, QACs are commonly used as disinfectants, antiseptics, preservatives, and detergents. Occupational exposure to QACs has been reported as a risk factor for NMBA anaphylaxis, but little is known about the sensitization mechanism and the capacity of these molecules to elicit an immune response. We aimed to establish the immunogenicity of QACs representative of the main existing chemical structures.

Methods

We measured the sensitization potential of seven QACs (two polyquaterniums, three alkyl-ammoniums and two aromatic ammoniums) by using two standard dendritic cells (DCs) models (THP-1 cell line and monocyte derived-dendritic cells). The allergenicity of the sensitizing compounds was further tested in heterologous and autologous T-cell-DC co-culture models.

Results

Amongst the seven molecules tested, four could modulate activation markers on DCs, and thus can be classified as chemical sensitizers (polyquaterniums-7 and -10, ethylhexadecyldimethylammonium and benzethonium). This activation was accompanied by the secretion of pro-inflammatory and maturation cytokines. Furthermore, activation by polyquaternium-7 could induce T-cell proliferation in heterologous and autologous coculture models, demonstrating that this molecule can induce a specific CD4⁺ T cell response.

Conclusions

We provide evidence at the cellular level that some QACs can elicit an immune response, which could be in line with the hypothesis of these molecules' role in NMBA sensitization.

背景：在许多国家，神经肌肉阻断剂（NMBA）是导致围手术期过敏性休克的首要原因。流行病学研究发现，含有季铵的阿片类药物芬可待因是致敏源之一。然而，在无法获得酚可定的国家也存在 NMBA 过敏性休克，这促使人们提出了其他致敏分子的假设，最有可能是季铵化合物（QAC）。事实上，QACs 常用作消毒剂、防腐剂、防腐剂和洗涤剂。据报道，职业性接触 QACs 是导致 NMBA 过敏性休克的一个危险因素，但人们对这些分子的致敏机制和引起免疫反应的能力知之甚少。我们的目的是确定代表现有主要化学结构的 QAC 的免疫原性：我们使用两种标准树突状细胞（DCs）模型（THP-1 细胞系和单核细胞衍生树突状细胞）测量了七种 QACs（两种聚季铵盐、三种烷基铵和两种芳香族铵）的致敏潜力。在异源和自源 T 细胞-DC 共培养模型中进一步测试了致敏化合物的过敏性：结果：在测试的七种分子中，有四种能调节 DC 的活化标记，因此可归类为化学致敏剂（聚季铵盐-7 和-10、乙基十六烷基二甲基铵和苄基铵）。这种激活伴随着促炎细胞因子和成熟细胞因子的分泌。此外，在异源和自体共培养模型中，聚季铵盐-7 的活化可诱导 T 细胞增殖，这表明该分子可诱导特定的 CD4+ T 细胞反应：我们在细胞水平上提供了一些 QACs 可以引起免疫反应的证据，这可能与这些分子在 NMBA 致敏中发挥作用的假设相符。

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引用次数: 0

Estimated prevalence and incidence of hypersensitivity pneumonitis in Japan 日本超敏性肺炎的估计流行率和发病率。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.06.002

Tsukasa Okamoto , Mariko Hanafusa , Taketomo Abe , Takashi Shimamura , Masaru Ito , Yoko Wakai , Torahiko Jinta , Katsuyuki Higa , Yasuhiro Kondoh , Yasumi Okouchi , Ryo Okuda , Masashi Bando , Takafumi Suda , Hiromi Tomioka , Takeo Fujiwara , Masato Takase , Shigemi Yoshihara , Hiroshi Odajima , Yasunari Miyazaki

Background

The latest guidelines on hypersensitivity pneumonitis (HP) categorise the disease as either fibrotic or non-fibrotic because of the greater clinical utility of this stratification. However, the prevalence and incidence of fibrotic and non-fibrotic HP are unknown. This study assessed the exact prevalence and incidence of fibrotic and non-fibrotic HP in Japan in 2021.

Methods

For adults, the study hospitals were selected by stratified random sampling according to numbers of beds. The sampling rate was set at about 20%. The questionnaire survey was submitted to the target hospitals. For pediatric cases, a survey was distributed to all members of the Japanese Society of Pediatric Pulmonology and Japanese Society of Pediatric Allergy and Clinical Immunology.

Results

Regarding adult cases, in total, 575 facilities responded to the survey, resulting in a response rate of 36.4%. The estimated prevalence and incidence of fibrotic HP were 6.3 and 2.5 per 100,000 population, respectively, versus 3.6 and 2.0 per 100,000 population, respectively, for non-fibrotic HP. Both fibrotic and non-fibrotic HP were more prevalent in southern Japan (Kyushu) and less prevalent in northern Japan (Hokkaido). The incidence of non-fibrotic HP was significantly lower in December than in the other months (relative risk ratio = 0.36, p < 0.001). Three cases of fibrotic HP and five cases of non-fibrotic HP were identified in children.

Conclusions

This study determined the prevalence and incidence of fibrotic and non-fibrotic HP in Japan for the first time.

背景：最新的超敏性肺炎（HP）指南将该病分为纤维化和非纤维化两类，因为这种分层方法的临床实用性更高。然而，纤维化和非纤维化超敏性肺炎的患病率和发病率尚不清楚。本研究评估了 2021 年日本纤维化和非纤维化 HP 的确切患病率和发病率：对于成人，研究医院根据床位数进行分层随机抽样。抽样率设定为约 20%。向目标医院提交问卷调查。对于儿科病例，向日本儿科肺病学会和日本儿科过敏与临床免疫学会的所有会员发放了调查问卷：在成人病例方面，共有 575 家医院对调查做出了回复，回复率为 36.4%。据估计，纤维化型高血压的患病率和发病率分别为每 10 万人 6.3 例和 2.5 例，而非纤维化型高血压的患病率和发病率分别为每 10 万人 3.6 例和 2.0 例。纤维化和非纤维化 HP 在日本南部（九州）的发病率较高，而在日本北部（北海道）的发病率较低。非纤维化 HP 的发病率在 12 月份明显低于其他月份（相对风险比 = 0.36，p 结论：非纤维化 HP 的发病率在 12 月份明显低于其他月份（相对风险比 = 0.36，p）：本研究首次确定了纤维化和非纤维化 HP 在日本的流行率和发病率。

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引用次数: 0

T follicular helper and memory B cells in IgE recall responses T 滤泡辅助细胞和记忆 B 细胞在 IgE 召回反应中的作用。

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.10.003

Joshua F.E. Koenig

IgE antibodies raised against innocuous environmental antigens cause allergic diseases like allergic rhinitis, food allergy, and allergic asthma. While some allergies are often outgrown, others (peanut, shellfish, tree nut) are lifelong in the majority of individuals. Lifelong allergies are the result of persistent production of allergen-specific IgE. However, IgE antibodies and the plasma cells that secrete them tend to be short-lived. Persistent allergen-specific IgE titres are thought to be derived from the continued renewal of IgE plasma cells from memory B cells in response to allergen encounters. The initial generation of allergen-specific IgE is driven by B cell activation by IL-4 producing Tfh cells, but the cellular and molecular mechanisms of the long-term production of IgE are poorly characterized. This review investigates the mechanisms governing IgE production and Tfh activation in the primary and recall responses, towards the objective of identifying molecular targets for therapeutic intervention that durably inactivate the IgE recall response.

针对无害环境抗原产生的 IgE 抗体会导致过敏性疾病，如过敏性鼻炎、食物过敏和过敏性哮喘。有些过敏症通常会逐渐消失，而有些过敏症（花生、贝类、树坚果）对大多数人来说则是终身性的。终身过敏是过敏原特异性 IgE 持续产生的结果。然而，IgE 抗体和分泌它们的浆细胞往往是短暂的。持续的过敏原特异性 IgE 滴度被认为是在遇到过敏原时，记忆 B 细胞不断更新 IgE 浆细胞而产生的。过敏原特异性 IgE 的最初产生是由 B 细胞被产生 IL-4 的 Tfh 细胞激活驱动的，但 IgE 长期产生的细胞和分子机制尚不清楚。这篇综述研究了原发性和召回反应中 IgE 生成和 Tfh 激活的机制，目的是确定治疗干预的分子靶点，以持久灭活 IgE 召回反应。

引用次数: 0

IF 6.2 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2025-01-01 DOI: 10.1016/j.alit.2024.08.003

Makoto Nagata , Ryo Yamaguchi , Makiko Usami , Mami Orimo , Masato Ishida

引用次数: 0